LIVING POSITIVELY WITH BREAST CANCER
Dr Matin Mellor Abdullah, Consultant Clinical Oncologist at SJMC | Tham Lai Chee, Breast Cancer Survivor
A diagnosis of breast cancer still strikes fear in many women’s hearts. But Tham Lai Chee’s story of courage and optimism will lift the hearts of women living with breast cancer. She joins us along with consultant clinical oncologist Dr Matin Mellor Abdullah to share her breast cancer journey, in conjunction with Breast Cancer Awareness Month in October.
Breast cancer survivor Madam Tham shares her experience & survivor journey
BFM Presenter: Madam Tham is sharing about her journey of being diagnosed and treated for breast cancer. Dr Matin is sharing about the importance of early diagnosis of breast cancer and options for treatment for women diagnosed today. The picture of breast cancer is very different today from what it was many years ago. Madam Tham, you started to talk a little bit about surgery. Perhaps you could give us the overall picture of what you underwent for treatment of your breast cancer.
Madam Tham: My treatment was to do chemotherapy and radiotherapy, referred by my oncologist. So, I had 6 rounds of chemo and 15 times of radiotherapy.
BFM Presenter: Did you undergo surgery, mastectomy as well?
Madam Tham: Oh yes, of course we have to do the surgery first, then only we do the treatment.
BFM Presenter: Were you afraid of having to undergo the mastectomy?
Madam Tham: Like I said before, whatever the doctor said, I listened to the doctor. Whatever the doctor said is best for us, so I did what the doctor said.
BFM Presenter: Dr Matin, she is a model patient.
Dr Matin Mellor: Very trusting.
BFM Presenter: But that is so important, that trust between the patient and the doctor, and of course the patient’s family who are there to provide support as well. Which, both of you have already described what that would look like. Madam Tham, as you were going through the chemo and radiotherapy, what were some of the side effects you experienced and how did you manage those?
Madam Tham: There are ups and downs along the way, so to me, I don’t really have a difficult time during my treatment. It was just very smooth all the way during my treatment. Maybe because of the good medication that I had?
Overcoming reservations on breast cancer surgery, chemotherapy & radiotherapy
BFM Presenter: Dr Matin, do patients still have reservations about treatments like surgery, chemotherapy & radiotherapy?
Dr Matin Mellor: Patients do have reservations. I think we can’t discount that fact because these are going to be done onto your physical self. Of course, you feel the harm that can be induced to you. But the harm from the cancer itself is worse in some ways. So again, it is important to educate the patient about the surgery, radiotherapy, chemotherapy, and the whole works about the treatment.
Of course, things have changed. There are many advances with regards to surgery. In the past, mastectomy used to be the standard of care, but there are advances now with this thing called onco-plastic surgery where plastic surgery reconstruction is done at the same sitting as the removal of the lump at the breast. Then cosmetically, that that gives a good aesthetic outcome. But more importantly for us, does it give good oncological outcomes in terms of the local control. And most surgeons feel that because you get the equivalent outcome, you can do oncoplastic surgery and still reduce the risk of local recurrence in the breast.
I think a lot of fear of treatment comes from chemotherapy. It’s not unusual for patients to tell us that when they read about chemotherapy, they really cringe in fear because of the list of side effects that really demoralises them.
But I always encourage them to speak, like Madam Tham, to the Breast Cancer Welfare Association (BCWA) where they have peer discussion. Because, if you look at the list of side effects from the books, from google, the list is very intimidating. But in practice, a lot of those side effects are being described, but patients experience a different degree of it. So, talking to patients who have been undergone chemotherapy does alleviate quite a lot of those fears.
We as clinicians and breast cancer care nurses that give chemotherapy also has to assure them along the way. We never say that there is not going to be side effects, because there are going to be some side effects. But those side effects are manageable, and the goal of the treatment of course is to increase the chance of cure.
So, when individuals with breast cancer understands all that, they are a bit more motivated to undergo the treatment to ensure the best outcome possible.
BFM Presenter: When you say cure, what do you mean?
Dr Matin Mellor: Cure is by definition, the non-recurrence of the disease in the years to come. Now, this is another point of discussion, with regards to the definition of cure in cancer. By definition, if you say cured, cured means you’ve got no disease, no disease in the years to come, but we really cannot confirm that this is going to be the case. So, in oncological terms, the term that we use is “in-remission”. Meaning, with the scans that you have, the patient does not have any disease, then they are in-remission. And we know that for a lot of diseases, the longer the period of remission, the lower the risk of recurrences. And therefore, we can look back and say that the cancer is cured of cancer in that situation.
But we never say that a patient is cured at the end of the treatment that we have done, because there can be rocky roads ahead and with cancer, the disease can come back in the future as well. So that also needs to be understood, to ensure compliance with follow up and treatments as well.
Live a positive life and do regular breast self-examinations
BFM Presenter: Dr Matin what is your message for women living with breast cancer and also for women who are looking to prevent breast cancer.
Dr Matin Mellor: For women with breast cancer, I think it’s important to live life to the fullest, develop new hobbies like Madam Tham, and engage in those activities that make you happy and make new friends. I think what Madam Tham has describes the last hour also encapsulates what every cancer survivor should do. Do what you like most, enjoy it and hopefully you get an equally good outcome like Madam Tham.
With regards to breast cancer prevention, we can’t prevent everything. But to minimise the risk of developing breast cancer, it’s important for women to maintain an ideal body weight, exercise regularly, do perform breast self-examination regularly and properly. There are many training aids available online to demonstrate to you how to examine your breast properly, because there are 4 quadrants in the breast and the area around the nipple as well that has to be examined properly.
When appropriate, sign up to do a breast screening program.